Neonatal is one of the least pursued specializations in the nurse practitioner (NP) field, but one of its highest-paying. Indeed, of 3,812 respondents to a questionnaire from the American Association of Nurse Practitioners (AANP) for its 2011 national compensation survey, just 1.6 percent of them said they were neonatal nurse practitioners (NNPs). At the same time, these nurse practitioners reported receiving the highest base salary among eight specialty NP areas. But what do NNPs do? NNPs help provide care and treatment for infants in critical care intensive care units (ICUs), and also take on leadership roles due to their advanced graduate-level education. Their expertise might be put to use in Level II or Level III neonatal intensive care unit (NICU), which are for infants born prematurely or with moderate or severe illnesses. NPs go into this specialty area for a variety of reasons beyond just pay. A study published in the Journal of Nurse Practitioners called “Neonatal Nurse Practitioners: Influencers on Career Choice” (login required) shows that of 367 responding NNPs, 55 percent indicated that their decision to enter the neonatology field was based on interest in that patient population, while 26 percent said it was due to greater autonomy and the ability to offer comprehensive care.
The majority of nurse practitioners have an average of 10 years of experience in nursing before deciding to pursue the education to become a nurse practitioner. In fact, 67 percent of respondents to the aforementioned survey published in the Journal for Nurse Practitioners indicated they made the decision to work as an advanced practice registered nurse in neonatology while actually practicing as a registered nurse. According to the AANP study, NNPs had a base neonatal nurse practitioner salary of $107,550. In financial terms, this compares favorably to every other specialty NP area.
|Specialty||Base Salary||Income Total|
|*Supplied through the 2011 AANP National NP Compensation Survey|
Indeed, the only base salary and income total to come close to those for NNPs were those for NPs working in psychiatric and mental health. As a note, the average base salary for all NPs was $91,310 while the average income total was $98,760.
Overall nurse practitioner salary can vary based on time of the job and past experience, although the AANP notes that new NPs are receiving competitive salaries. Those who have between one to five years of experience made a mean hourly wage of $42.51, the survey shows. Of course, this is not specific to NNPs but all NPs in general. Given that NNPs have higher base salaries than average and higher total income than average, it might be assumed that their mean hourly wage is also higher than the average. Indeed, overall, however, total income seems to be highest for NPs (of all specialties) who have 16 to 20 years of experience, with their total income reaching $106,800. This compares with $92,210 for those with one to five years of experience and $101,080 for those with 20 or more years. Unfortunately, the AANP survey does not break down NP pay by past experience for specialty area.
One of the highest paying areas for NPs in general is the Plains area (Nebraska, North Dakota and several other states) where the total income was $124,450. This was followed by the Far West, including states such as California, Hawaii and others, where total income averaged $107,518, according to the AANP study. Providing another source, the Bureau of Labor Statistics shows that the highest mean wages vary by state with these five having the highest NP pay: Alaska: $111,800; California: $110,590; Oregon: $107,560; Hawaii: $106,770 and Massachusetts: $105,010.
Salary.com lists the median salary for neonatal nurse practitioners as $106,083. Nurses interested in a NNP career can also look up median salary by state, and then look at any number of cities listed within that state for further information on pay in metropolitan areas. NNP median wages, listed by salary.com, as of 2014, in five U.S. metropolitan areas were:
In addition to pay, NPs (including NNPs) can receive many other benefits on the job. This can include health insurance, vacation, an educational allowance and retirement plan. Additionally, 31 percent of respondents (up from 24.5 percent in 2008) to the AANP 2011 National NP Compensation Salary said they were given incentive bonuses. Most often, this related to the number of patient ‘encounters’ they had, but was also tied in to practice revenue and quality measures and outcomes. With a 2010 study in Pediatric Journal showing that 31 states had less than 100 NNPs, there may be many opportunities for registered nurses who pursue advanced training in this specialty area.